Park House

On this page

• Overview
• Learning culture
• Safe systems, pathways and transitions
• Safeguarding
• Involving people to manage risks
• Safe environments
• Safe and effective staffing
• Infection prevention and control
• Medicines optimisation

People had not always been kept safe as the provider had not always identified risks associated with people’s environment. Staff did not always know what to do in the event of a fire and we were not assured the provider had full oversight of the health and safety at Park House. We fed our concerns back to the provider and registered manager who took immediate action to improve this. There were systems in place to ensure risks to people were reduced. Staff knew people well and knew how to provide them with the support they needed. People were protected from the risk of abuse. There were enough staff to support people. Staff had the training and knowledge they needed to support people. When things went wrong action was taken to reduce the risk of events re-occurring. People and their relatives were happy with the support provided.

This service scored 72 (out of 100) for this area. Find out what we look at when we assess this area and How we calculate these scores.

We did not look at Learning culture during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Safe systems, pathways and transitions during this assessment. The score for this quality statement is based on the previous rating for Safe.

We spoke with 4 members of staff about safeguarding. They understood their role in identifying and reporting concerns internally. Whilst staff were not confident about external agencies they could contact if they had safeguarding concerns, they knew where to find this information. They were confident in the registered manager's responsiveness to any concerns.

Every family member spoken to confirmed they were happy with the care that their relative was receiving and had no concerns about their overall safety at Park House. Relatives told us there was an open and friendly approach, and if they needed to speak to somebody there was always someone available. One relative told us, “I think what gives me the most comfort is that there is no question of ill treatment. You can tell when the staff come in to see [loved one] that [loved one] is pleased to see them” and, “[Loved one] is absolutely safe. I am 100% confident in [loved one] being there and have no concerns at all.”

We were not assured the provider was working in line with the Mental Capacity Act 2005. Capacity assessments and best interest decisions had been made however they did not always record the involvement of relevant person such as relatives holding an LPA (Lasting Power of Attorney). This was not in line with the Mental Capacity Act 2005 or the providers own policy and had not been identified through any governance checks of the home. This was a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014. We fed this back to the provider and registered manager who took immediate action to improve this. We were unable to assess the sustainability of this at this inspection. People can only be deprived of their liberty when this is in their best interests and legally authorised under the Mental Capacity Act (MCA). In care homes this is usually through MCA application procedures called the Deprivation of Liberty Safeguards (DoLS). Some people living at the service were deprived of their liberty in order to support them to remain safe. Where this was the case, we found the appropriate legal authorisations were in place. People were protected from the risk of abuse. There were systems in place to enable staff to report concerns should they arise. The provider had appropriate safeguarding policies and process in place. Staff were provided with guidance on different types of abuse and how to raise concerns if these arose. Staff had undertaken training in safeguarding to provide them with guidance on types of abuse and reporting concerns.

Relatives told us they felt any risks that their relative could be exposed to were appropriately managed. Relatives told us they were consulted and involved in decision making where appropriate.

We observed people were supported safely. People in a communal area all had access to drinks and the equipment they needed to move safely.

We spoke with 4 members of staff. They understood the risks people faced and the measures in place to mitigate those risks. They spoke about supporting people to understand risks and they were able to reflect on how people's views were respected. For example, one person chooses to sleep in her chair despite the associated risks. The registered manager described how they sought to understand people's views and how best to support them from assessment onwards.

We were not assured risks associated with poor oral hygiene had always been identified. For example, we saw a person who required assistance twice per day with oral hygiene according to their care plan. Whilst staff told us they provided this care, there were no records of any assistance being provided by staff in either care records or the specific oral health section of their records and this had not been identified by any governance checks. Risk assessments were in place for a range of potential risks to people including those associated with mobility, health, and isolation however the records we saw were not always reflected in observed practice or staff knowledge. For example, a person told us they had no underwear on. Staff advised us that the person often removed their incontinence pad however there were no records to reflect this behaviour or how staff should support the person to ensure their dignity was protected. Governance systems had not identified these concerns. This was a breach of Regulation 17 (Good Governance) of the Health and Social Care Act 2008 (Regulated Activities) Regulations 2014.

We were not assured the provider had full oversight of health and safety at Park House. Fire safety was not safely managed, we saw and heard conflicting information about fire drills and fire door checks, and staff understanding was not consistent with the providers own fire policy and current good practice guidance. Water hygiene was not effectively managed. We found some records of temperatures and flushing of infrequently used outlets, but these did not identify which outlets had been checked. There was also not a robust risk assessment and scheme of control from a competent person. Whilst we found no impact of harm there had been a lack of robust governance to ensure people were safe in their environment. This was a breach of regulation 17 of the Health and Social Care Act. We discussed our findings with the registered manager who immediately took action to ensure a safe environment. This included further training with staff on how to evacuate people in the event of an emergency. We were not able to assess the sustainability of these changes.

Staff did not always understand how to evacuate people in an emergency. The registered manager was open and honest and told us checks had not always been completed as they should have been to ensure people were kept safe.

We observed a fire door wedged open, damaged plaster by a person’s bed and 2 unrestricted windows on the first floor. Staff told us the plaster repair had been needed for some time and that they wedged the doors when the fire doors were not working. We discussed these concerns with the provider and registered manager who took immediate actions to address these issues. We have not been able to check the sustainability of these actions.

Relatives felt the environment at Park House was safe and well maintained. However, relatives were not always aware of what procedures were in place in case of an emergency. One relative told us, “The house always seems to be clean, tidy and well organised. The staff all appear to be happy to work there and there is a homely feel about it.”

We saw 7 people engaging in a quiz with the activities officer. They participated at their own level and the staff member was constantly aware of peoples differing abilities and that they may need more time to communicate or for all to be quiet to hear them. People were engaged and enjoyed the conversation and companionship the session offered.

We spoke with 4 staff who told us they felt well supported. They told us their training supported them to carry out their roles effectively. They told us there were enough staff to meet people's needs although recently it had been more stretched when they had been supporting people with higher dependency. This was acknowledged to be the case by the registered manager. The registered manager told us they were already aware of some of the feedback we received from people and would be addressing issues with staff in forthcoming supervisions about the need for patience and compassion. This meant there was a delay in addressing an important impact on people's experience.

One person told us staff came quickly when they press their alarm call bell. Another person told us they felt mostly well looked after indicating staff were available when needed. Relatives told us there were enough kind, friendly and competent staff to meet the needs of people living at Park House. Comments from relatives, included, “I have always found the staff very approachable. When I visit, they normally always provide me with a cup of tea” , “I have never felt that there is a shortage of staff. I think there are ample numbers. The staff are just so incredibly caring, helpful and with a good sense of humour. They are happy and stay there, and look after [loved one] incredibly well. I think they are well trained from the fact that the care they provide is excellent” and, “The staff are all very approachable and friendly when you visit. There are always quite a lot of staff on, and they appear to be well trained. I have witnessed them hoisting [person] and they do this very safely and professionally. All the staff seem very competent and know what they are doing.”

We reviewed 2 recruitment records for contracted staff members and a record for an agency staff member. All necessary pre-employment checks had taken place and all 3 staff had completed a thorough induction. For example, there were complete employment histories, relevant references and interview notes had been completed fully. There were robust processes to ensure staff undertook the training that had been identified as essential for their role.

We did not look at Infection prevention and control during this assessment. The score for this quality statement is based on the previous rating for Safe.

We did not look at Medicines optimisation during this assessment. The score for this quality statement is based on the previous rating for Safe.